Arthroscopic management of knee synovial chondromatosis: a systematic review of outcomes and recurrence.

BACKGROUND

Knee synovial chondromatosis (SC) is a rare joint disorder involving loose cartilaginous bodies, leading to pain, swelling, and impaired function. Arthroscopy has become a primary treatment option, but its efficacy and recurrence rates remain debated. This systematic review evaluates the effectiveness and safety of arthroscopic interventions, focusing on loose body removal, partial synovectomy, and total synovectomy.

METHODS

A systematic search of PubMed and EMBASE (1985-2024) identified studies on arthroscopic treatment of knee SC, adhering to PRISMA guidelines. Inclusion criteria targeted original studies detailing outcomes of loose body removal with or without synovectomy. Data on patient demographics, surgical techniques, and outcomes were extracted, with recurrence as the primary outcome. Qualitative synthesis was conducted due to heterogeneity among studies.

RESULTS

The review included 84 patients (median age: 36 years, range: 7-67). Loose body removal alone was performed in 57.8%, partial synovectomy in 30.9%, and total synovectomy in 13%. Median follow-up was 28 months. Recurrence occurred in 22.6%, predominantly after loose body removal alone. Complication rates were negligible, with only one reported instance unrelated to the arthroscopic procedure.

CONCLUSIONS

Arthroscopic treatment is safe and effective for knee SC. Recurrence rates underscore the importance of synovectomy in preventing disease recurrence. Total synovectomy may offer superior outcomes for advanced cases. Further research with standardized protocols and extended follow-up is needed to optimize treatment strategies.